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Systemic and Local Allergic Insect Sting Reaction From The Epidemiological, Diagnostic a Therapeutic Point of View
Vachová, Martina ; Panzner, Petr (advisor) ; Kučera, Petr (referee) ; Krčmová, Irena (referee)
Hymenoptera venom allergy threatens the patients with severe, often life threating anaphylactic sting reaction. Proper diagnostics and treatment are therefore crucial for the patient with this diagnosis and should be performed by an experienced allergist. We aimed to provide a comprehensive look at these patients, from the epidemiological, diagnostic and therapeutic point of view. Initially, we focused on predictors of severe systemic sting reactions. Then we followed by evaluation of the utility of available laboratory diagnostic methods and by monitoring of immunological parameters during venom immunotherapy. We met all these goals. We detected higher age, sting localization in the head region and male gender as predictors of severe systemic sting reaction. We also evaluated the clinical utility of all diagnostics methods, and we even suggested the possible way, how to optimize the diagnostic procedure in patients with Hymenoptera venom allergy. We noticed significant changes in immunological parameters during venom immunotherapy. Due to a low number of stings during treatment, we have not been able to evaluate the clinical relevance of these changes yet.
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Epidemiology of hypersensitivity in patients with atopic dermatitis and its clinical relevance
Liška, Martin ; Panzner, Petr (advisor) ; Pizinger, Karel (referee) ; Petrů, Vít (referee)
Epidemiology of hypersensitivity in patiens with atopic dermatitis and its clinical relevance MUDr. Martin Liška Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease which is often accompanied by hypersensitivity to various allergens. While food allergens have been considered to play a major role in AD pathogenesis, there is also increasing evidence that aeroallergens are involved. The clinical relevance of detected hypersensitivity was also intensively investigated in last decades. Aims of the study: Our aim was to find out the frequency of hypersensitivity to airborne allergens in AD patients and its clinical relevance using various evaluation standards. Methods: We tested 71 patients (median age 5 years) with AD for hypersensitivity to grass and birch pollen, Dermatophagoides pteronyssinus and Dermatophagoides farinae using atopy patch test (APT), skin prick test (SPT) and specific IgE measurement. The sensitivity (SE) and specificity (SP) of the tests were calculated on the basis of personal history of AD exacerbation, SCORAD changes and the number of days with need for topical anti- inflammatory treatment (AITD) in relation to exposure to the allergens being tested. Results: APT was positive in 45 patients, mostly to Der.farinae (n = 37). SPT and/or specific IgE were positive in 42...
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Epidemiological and Clinical Aspects of Food Allergy
Bělohlávková, Simona ; Panzner, Petr (advisor) ; Krčmová, Irena (referee) ; Rybníček, Ondřej (referee)
The prevalence of food allergy is rising rapidly in last two decades. It almost doubled between 1999 and 2011. It currently occurs in 6-8 % of children and 3-6 % of adults in Europe, and about 10 % in the US. Food allergy is more common in children than in adults and it's prevalence differs in industrialized/westernized countries. The spectrum of most frequent triggering foods, symptoms of food allergy and types of food sensitization are geographically different. Until now, we have only limited data available of food allergies in patients in the Czech republic. The aim of the study was to gather epidemiological data of food allergies in patients from the Czech republic. We used electronic registry DAFALL (Database of Food Allergies) to prospectively collect data from patients with newly diagnosed food allergy. During the 3 years of follow up, 1747 patients with IgE or non-IgE mediated food allergy were enrolled into the registry. 22,1 % of them were infants, 26,1 % children at the age of 1 to 6 years, 24,9 % kids between 7 and 18 years and 26,9 % adults. We compared the most frequent types of food triggering reactions in different age groups, severity of symptoms, the prevalence of IgE sensitization considering available data from the other parts of Europe. We have found some specific patterns of...
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Systemic and Local Allergic Insect Sting Reaction From The Epidemiological, Diagnostic a Therapeutic Point of View
Vachová, Martina ; Panzner, Petr (advisor) ; Kučera, Petr (referee) ; Krčmová, Irena (referee)
Hymenoptera venom allergy threatens the patients with severe, often life threating anaphylactic sting reaction. Proper diagnostics and treatment are therefore crucial for the patient with this diagnosis and should be performed by an experienced allergist. We aimed to provide a comprehensive look at these patients, from the epidemiological, diagnostic and therapeutic point of view. Initially, we focused on predictors of severe systemic sting reactions. Then we followed by evaluation of the utility of available laboratory diagnostic methods and by monitoring of immunological parameters during venom immunotherapy. We met all these goals. We detected higher age, sting localization in the head region and male gender as predictors of severe systemic sting reaction. We also evaluated the clinical utility of all diagnostics methods, and we even suggested the possible way, how to optimize the diagnostic procedure in patients with Hymenoptera venom allergy. We noticed significant changes in immunological parameters during venom immunotherapy. Due to a low number of stings during treatment, we have not been able to evaluate the clinical relevance of these changes yet.
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Epidemiology of hypersensitivity in patients with atopic dermatitis and its clinical relevance
Liška, Martin ; Panzner, Petr (advisor) ; Pizinger, Karel (referee) ; Petrů, Vít (referee)
Epidemiology of hypersensitivity in patiens with atopic dermatitis and its clinical relevance MUDr. Martin Liška Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease which is often accompanied by hypersensitivity to various allergens. While food allergens have been considered to play a major role in AD pathogenesis, there is also increasing evidence that aeroallergens are involved. The clinical relevance of detected hypersensitivity was also intensively investigated in last decades. Aims of the study: Our aim was to find out the frequency of hypersensitivity to airborne allergens in AD patients and its clinical relevance using various evaluation standards. Methods: We tested 71 patients (median age 5 years) with AD for hypersensitivity to grass and birch pollen, Dermatophagoides pteronyssinus and Dermatophagoides farinae using atopy patch test (APT), skin prick test (SPT) and specific IgE measurement. The sensitivity (SE) and specificity (SP) of the tests were calculated on the basis of personal history of AD exacerbation, SCORAD changes and the number of days with need for topical anti- inflammatory treatment (AITD) in relation to exposure to the allergens being tested. Results: APT was positive in 45 patients, mostly to Der.farinae (n = 37). SPT and/or specific IgE were positive in 42...
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Food allergy to wheat flour proteins
Šotkovský, Petr ; Tučková, Ludmila (advisor) ; Panzner, Petr (referee) ; Prokešová, Ludmila (referee)
THESIS SUMMARY Food allergy is one of the frequent disorders and its incidence in paediatric as well as adult population is continuously rising, having doubled in the last two decades. Although wheat belongs to major food allergens and is a staple food in most diets, we have only little knowledge of wheat proteins causing IgE mediated hypersensitivity reaction. Diagnostic approaches of food allergy to wheat have a high sensitivity, but low specificity. Poor predictability and specificity may be associated with the insufficient purity of wheat extracts used in sIgE assays or with the lack of major allergens in these extracts. In the first step, we characterized 19 potential allergens recognised by IgE Abs of allergic patients, using proteomic techniques (1-DE, 2-DE, MALDI-TOF, QTOF and LCQDECA nLC-MS/MS ion trap technique). We identified these IgE-binding molecules such as: α-amylase inhibitors, β-amylase, profilin, serpin, β-D-glucan exohydrolase and 27K protein. To quantify sIgE in patient's sera we developed ELISA using the whole wheat extract and two commercially available α-amylase inhibitors. Second, we developed a procedure that allows isolation of wheat allergens from natural sources using Rotofor cell and HPLC. Twenty-seven potential wheat allergens have been successfully identified; of these, the...
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Monitoring of airway inflammation in patients with various types of bronchial obstructionMonitoring of oxidative stress biomarkers in exhaled breath condensate of patients with severe refractory asthma
Sedlák, Vratislav ; Salajka, František (advisor) ; Skřičková, Jana (referee) ; Panzner, Petr (referee)
Monitoring of airway inflammation in patients with various types of bronchial obstruction. Monitoring of oxidative stress biomarkers in exhaled breath condensate of patients with severe refractory asthma. Background: Asthma is chronic inflammatory disease associated with bronchial hyperreactivity. Various cells plays and cellular products are involved in asthma pathogenesis. Oxidative stress plays also a significant role in mechanisms of asthma via action of reactive oxygen (ROS) and nitrogen (NOS) species. These free radicals develop from inflammatory airway reaction and from exogenous exposure of air-pollution (ozone, cigarette smoke). ROS and NOS and its products cause damage of bio- membranes, proteins and nucleic acid. Several studies showed correlation of asthma severity to intensity of oxidative stress. Aim of the study: The main goal of the study was to describe differences in concentrations of various markers of oxidative stress in exhaled breath condensate of severe refractory asthma (SRA) patients and healthy controls (HC). Secondary aim was to show correlation of oxidative stress intensity to severity of eosinophilic inflammation described by peripheral blood eosinophilia or exhaled nitric oxide concentration. Methodology: We harvested exhaled breath condensate in 40 SRA patients and 19...
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